Individual
MRS. BROOKE BUCKENTINE SIMONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2420 HERON LN, VICTORIA, MN 55386-4558
(952) 994-9440
Mailing address
516 DELAWARE ST SE, PHILLIPS-WANGENSTEEN BUILDING 2-200, MINNEAPOLIS, MN 55455-0356
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11322
MN
Other
Enumeration date
08/02/2011
Last updated
02/23/2016
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